On February 10, 2022 price inflation jumped by 7.5% over the past 12 months, its highest annual increase in 40 years. For employers and other health care purchasers that monitor their claims cost and utilization data religiously (who doesn’t?), this news prompts questions from purchasers about how inflation will impact their future health care spend.
In a prior blog article on the 2021 KFF Employer Health Benefits Survey, we noted that employers are in the eye of a hurricane and will have to confront some painful tradeoffs when costs spiral again. But the significant exceptions to employers’ “wait and see approach” to health care benefits during the first year of the COVID-19 pandemic are in the areas of telehealth and behavioral health, including at the intersection of the two.
Back in October 2019, we published a blog post on the challenges of building a high-performance network (HPN). We landed on the conclusion that an HPN should be designed with sensitivity to
In this blog post, we offer best practices for vendors preparing for “case study” presentations in the direct-to-employer context.
First of all, why case studies? Case studies are empirical inquiries that investigate a phenomenon in a real-world context.
When the RBP vendor and provider “agree” on a rate, who pays the difference? The RBP vendor or the employer? It depends – and the outcome will likely be reflected in the vendor’s administrative fee.
Suzanne Delbanco catches up with CJ Stimson, MD, JD, the Senior Vice President of Value Transformation at Vanderbilt University Medical Center (VUMC), to discuss Vanderbilt’s direct contract bundled payment arrangement for maternity care with Metro Nashville Public Schools (MNPS).
Employers and consumers are eager for solutions that attack health care cost inflation at its root cause. One prominent strategy is using reference-based pricing (RBP) models that anchor commercial rates to Medicare, or some other rationalized external benchmark. Like so many health care innovations, reference-based frameworks encompass multiple branching models, and as such the term “RBP” has come to mean different things to different stakeholders.
Unpacking the complexity of high-performance network design The National Business Group on Health (NBGH) predicted that by 2018 a staggering 61% of employers would offer narrow or high-performance networks (HPNs).
Take a moment now to think of all your monthly memberships and subscriptions – we’re willing to bet there’s at least one that you’re likely not using to its full
Nutrition interventions are gaining steam in health care world, and high-profile announcements from Lyft and BCBS at HIMSS19 are just icing on the cake. Whether it’s through medically-tailored meals or
“Act in such a way that you treat humanity, whether in your own person or in the person of any other, never merely as a means to an end, but
Employers are getting increasingly creative when it comes to health care coverage. Whether that means covering benefits on the cutting edge of medical care or figuring out ways to
If you blinked on February 20 of this year, you may have missed that the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule to loosen restrictions on
